A development study of pulmonary rehabilitation for patients with chronic lung disease in Uganda. Jones, R. Kirenga, B. Pooler, J. Katagira, W. Kasiita,

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Presentation transcript:

A development study of pulmonary rehabilitation for patients with chronic lung disease in Uganda. Jones, R. Kirenga, B. Pooler, J. Katagira, W. Kasiita, R. Enki, DG. Creanor, S. Barton, A. Singh, S Makerere University Lung Institute Aim: To investigate the acceptability of pulmonary rehabilitation (PR) in Kampala, for patients with Chronic Lung Disease including PTBLD. Methods: Programme : twice weekly for 6 weeks Exercise included resistance, endurance and flexibility as per international guidelines. Education included COPD causes in Africa- smoking, biomass smoke, respiratory infections, HIV and nutrition. Outcome measures – CCQ, PHQ-9 Karnofsky scale, Symptom questionnaire Incremental shuttle walk test Sit to Stand test Biometrics Medical Research Council / Department for International Development / Wellcome Trust Joint Global Health Trials Scheme RJ is Supported by PENCLARC NIHR funding Results: Recruitment & retention Outcomes for 39 patients completing data collection (mean (95% CI)) PR was very well received. Some patients reported life transforming improvements, especially in mood, fitness and social function. Amongst PTBLD patients,45% had chest pain prior to PR but only 24% 6 weeks after, and for haemoptysis 17% and 7% respectively. Conclusions: PR offers a new option for treatment for a neglected group of patients, who saw major improvements in their quality of life and exercise capacity. Unexpected reductions in chest pains and haemoptysis were noted in post TB patients. Future research: 3 RCTs are planned looking at PR in 1. post TB lung disorder 2. post-discharge after acute exacerbations 3. Stable COPD Implementation studies in Zambia, Kenya & Tanzania will follow. Bibliography: 1.Adeloye D, et al. Journal of Chronic Obstructive Pulmonary Disease 2015;12(1): Nici L, et al Am J Respir Crit Care Med 2006;173(12): Spruit. Am J Respir Crit Care Med 2013;188(8):e Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for Diagnosis, Management, and Prevention of COPD, Introduction : COPD and post-TB lung disorder (PTBLD) are growing problems in Africa. Drug treatments are seldom available or affordable. Patients suffer stigma and social isolation. Many patients are young and economically important. Pulmonary rehabilitation (PR) offers a sustainable, scalable treatment option but has not been tested in Africa for PTBLD or COPD. Outcome measureBaselineEnd of PR 6 weeks after end of PR CCQ total score1.8 (1.5, 2.0)1.0 (0.8, 1.2)0.8 (0.7, 1.0) PHQ-9 total score3.0 (1.5, 4.5)0 (0, 0)0.3 (0, 0.7) Karnofsky scale75.4 (73.6, 77.2)89 (87.4, 90.6)89.7 (87.6, 91.9) ISWT (meters)299 (268, 329)376.7 (340, 414)373.9 (334, 413) Sit to Stand time (seconds) 10.5 (9.5, 11.5)8.0 (7.3, 8.8)7.4 (6.8, 7.9) BMI21.9 (20.0, 23.9)22.7 (20.6, 24.7)22.9 (20.8, 25.0) PTBLDCOPDTotal Screened Assessed56152 Suitable Started Rehab Finished Rehab For further info see eposter PA3964; watch online video;